scholarly journals Validation of an Enclosed Blood Collection System in a Pediatric Laboratory

2018 ◽  
Vol 3 (1) ◽  
pp. 65-78
Author(s):  
Elizabeth P Weinzierl ◽  
Cindy Brawley ◽  
James L Adams ◽  
Beverly B Rogers
Keyword(s):  
Clinical Laboratory ◽  
Blood Collection ◽  
Collection System ◽  
Current Collection ◽  
Tube Type ◽  
Clinically Significant ◽  
Almost All ◽  
Automated Instruments ◽  
Adult Volunteers ◽  
Transfer Device

Abstract Background Preanalytical, analytical, and postanalytical issues are often magnified in pediatric laboratories, and traditional vacuum-based blood tubes can contribute to some of these issues. Because of this, we investigated adopting an enclosed blood collection system that can perform vacuum or gentle aspiration blood collection, eliminating syringes, transfer device, and transfer steps, as well as potentially minimizing preanalytical error in the pediatric laboratory. We embarked on a validation of this tube system, in comparison with our current collection tubes, across most in-house tests at a large pediatric hospital. Methods Twenty adult volunteers were recruited. Blood was drawn into lithium heparin, serum, EDTA, and citrate tubes of each commercial tube type for comparison. For some tests, remnant blood from pediatric syringe draws was used when available. Samples were then processed and analyzed across all general areas of the clinical laboratory, and correlations of the results from the 2 tube systems were performed. Results Across 95 tests in the core laboratory and blood bank, almost all demonstrated clinically acceptable comparisons, with most R values >0.90. Only 3 of 95 tests demonstrated clinically significant differences between the tube systems. Conclusions Our validation of the enclosed blood collection system demonstrated acceptable results when compared with our current collection tubes. Additionally, with some minor modifications, our automated instruments could utilize ultralow-volume tubes from the enclosed blood collection system for direct tube sampling, which is impossible using our current small-volume tubes with our main chemistry analyzer.

The integrated blood-collection system as a vehicle into complete clinical laboratory automation

1991 ◽  
Vol 37 (9) ◽  
pp. 1548-1556 ◽  
Author(s):  
R L Columbus ◽  
H J Palmer
Keyword(s):  
Clinical Laboratory ◽  
Integrated System ◽  
Diagnostic Instrument ◽  
Laboratory Evaluation ◽  
Blood Collection ◽  
Sample Collection ◽  
Collection System ◽  
Patient Identification ◽  
Plasma Extraction ◽  
Derivatives Of

Abstract A rationale is offered and methodology illustrated for integrating the fundamental steps involved in the collection and processing of blood for laboratory evaluation. The approach taken in the development of these concepts and components greatly extends the possibilities of laboratory systems integration without upsetting established modalities. A prototype design of the integrated blood-collection system integrates blood collection, cellular separations, sample transfer to stable storage without chemical mediators, and sample presentation for chemical analysis (e.g., precision metering) while preserving patient identification. A sophisticated, multi-chambered blood-collection container is the site of all blood sample processing and transfer steps. This device is supported by a compact, robotic centrifuge of unique design and a transfer mechanism to facilitate sample delivery for analysis within a diagnostic instrument. The confluence of these individual components into a single integrated system provides the means to completely automate the processing of blood samples, after sample collection, eliminating all manual transfer steps and any external exposure of blood interfaces outside the diagnostic instrument. Configurational derivatives of the Integrated Blood-Collection System offer choice of skin or venipuncture procedure, rapid plasma extraction for micro- or macro-collected volumes, and sample delivery by either aspiration or direct metering of discrete 10-microL samples from the collection container. The skin-puncture configuration provides the opportunity within a single device to collect and process up to 500 microL of sample by capillarity from a skin prick.

scholarly journals Clinical Evaluation of the Torq Zero Delay Centrifuge System for Decentralized Blood Collection and Stabilization

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1019
Author(s):  
Kyungjin Hong ◽  
Gabriella Iacovetti ◽  
Ali Rahimian ◽  
Sean Hong ◽  
Jon Epperson ◽  
...  
Keyword(s):  
Clinical Chemistry ◽  
Blood Collection ◽  
Test Results ◽  
Sample Collection ◽  
Rapid Separation ◽  
Cell Counts ◽  
Collection Device ◽  
Precision Study ◽  
Clinically Significant ◽  
Blood Specimens

Blood sample collection and rapid separation—critical preanalytical steps in clinical chemistry—can be challenging in decentralized collection settings. To address this gap, the Torq™ zero delay centrifuge system includes a lightweight, hand-portable centrifuge (ZDrive™) and a disc-shaped blood collection device (ZDisc™) enabling immediate sample centrifugation at the point of collection. Here, we report results from clinical validation studies comparing performance of the Torq System with a conventional plasma separation tube (PST). Blood specimens from 134 subjects were collected and processed across three independent sites to compare ZDisc and PST performance in the assessment of 14 analytes (K, Na, Cl, Ca, BUN, creatinine, AST, ALT, ALP, total bilirubin, albumin, total protein, cholesterol, and triglycerides). A 31-subject precision study was performed to evaluate reproducibility of plasma test results from ZDiscs, and plasma quality was assessed by measuring hemolysis and blood cells from 10 subject specimens. The ZDisc successfully collected and processed samples from 134 subjects. ZDisc results agreed with reference PSTs for all 14 analytes with mean % biases well below clinically significant levels. Results were reproducible across different operators and ZDisc production lots, and plasma blood cell counts and hemolysis levels fell well below clinical acceptance thresholds. ZDiscs produce plasma samples equivalent to reference PSTs. Results support the suitability of the Torq System for remotely collecting and processing blood samples in decentralized settings.

Do Deeper Levels of Cervical Biopsies Preceded by a Pap Smear Diagnosis of LSIL, ASCUS, or NILM/HPV+ Increase the Yield of Identifying Clinically Significant Lesions?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S163-S164
Author(s):  
K G Manjee ◽  
W G Watkin
Keyword(s):  
Pap Smear ◽  
Past History ◽  
Prior History ◽  
Cervical Biopsy ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Significant Difference ◽  
History Of ◽  
Clinically Significant ◽  
Almost All

Abstract Introduction/Objective Cervical biopsy is performed following an abnormal pap smear or positive HPV testing in an attempt to uncover clinically significant lesions [HSIL/invasive carcinoma (HSIL+)]. An excisional procedure is considered if biopsy confirms HSIL+. When preceded by pap smear of LSIL, ASCUS, NILM/HPV+ or persistent HPV, continued surveillance is recommended for biopsies showing no SIL or LSIL. In our laboratory, cervical biopsies are routinely sectioned at 3 levels. Deeper levels are often ordered when initial sections are non-diagnostic. p16 immunohistochemistry, with or without deeper levels, is often ordered to confirm HSIL, or to differentiate HSIL from mimics. In this study, we examine whether and in what clinical situations does obtaining additional levels uncover clinically significant lesions. Methods 430 cervical biopsies between January-May 2018, with recent cytology of LSIL, ASCUS or NILM/HPV+ were identified in the pathology database. HPV status (if known), final biopsy diagnosis and past history of LSIL/HSIL were recorded. For each biopsy, orders for additional levels and/or p16 immunohistochemistry were recorded resulting in 4 categories: C1-no additional levels or p16, C2-deeper only, C3-deeper+p16 and C4-p16 only. Final diagnoses were divided into HSIL+, LSIL and no SIL. Results There was no significant difference in prior history of LSIL/HSIL and HPV status between all categories. Biopsy results were as follows: HSIL+: 11/222 (5%) C1; 1/78 (1%) C2; 7/43 (16%) C3; 15/87 (17%) C4 LSIL: 91/222 (41%) C1; 7/78 (9%) C2; 16/43 (37%) C3; 35/87 (40%) C4 No SIL: 120/222 (54%) C1; 70/78 (90%) C2; 20/43 (46%) C3; 37/87 (42%) C4 The average number of additional levels in C2 and C3 was 3.8 and 1.8, respectively. Conclusion Deeper levels alone did not enhance the detection of HSIL+. Almost all LSIL/HSIL were detected when initial levels were diagnostic or suspicious and supported by p16 immunohistochemistry. 3 levels are adequate to detect clinically significant lesions.

scholarly journals Noninvasive Evaluation of Portal Hypertension Using a Supervised Learning Technique

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Mindaugas Marozas ◽  
Romanas Zykus ◽  
Andrius Sakalauskas ◽  
Limas Kupčinskas ◽  
Arūnas Lukoševičius
Keyword(s):  
Portal Hypertension ◽  
Supervised Learning ◽  
Evaluation Method ◽  
Clinical Laboratory ◽  
Transient Elastography ◽  
Venous Pressure ◽  
Noninvasive Evaluation ◽  
Noninvasive Methods ◽  
Supervised Learning Algorithms ◽  
Clinically Significant

Portal hypertension (PHT) is a key event in the evolution of different chronic liver diseases and leads to the morbidity and mortality of patients. The traditional reliable PHT evaluation method is a hepatic venous pressure gradient (HVPG) measurement, which is invasive and not always available or acceptable to patients. The HVPG measurement is relatively expensive and depends on the experience of the physician. There are many potential noninvasive methods to predict PHT, of which liver transient elastography is determined to be the most accurate; however, even transient elastography lacks the accuracy to be a perfect noninvasive diagnostic method of PHT. In this research, we are focusing on noninvasive PHT assessment methods that rely on selected best-supervised learning algorithms which use a wide set of noninvasively obtained data, including demographical, clinical, laboratory, instrumental, and transient elastography measurements. In order to build the best performing classification meta-algorithm, a set of 21 classification algorithms have been tested. The problem was expanded by selecting the best performing clinical attributes using algorithm-specific filtering methods that give the lowest error rate to predict clinically significant PHT. The suggested meta-algorithm objectively outperforms other methods found in literature and can be a good substitute for invasive PHT evaluation methods.

scholarly journals CLINICAL FEATURES OF TOXIC JAW BONE OSTEOMYELITIS IN DRUG ADDICTS

2021 ◽  
Vol 74 (2) ◽  
pp. 263-267
Author(s):  
Oleh S. Fitkalo ◽  
Roman Z. Ohonovskyi ◽  
Khrystyna R. Pohranychna ◽  
Yaroslav P. Nahirnyi ◽  
Andriy V. Netlyukh
Keyword(s):  
Clinical Laboratory ◽  
Maxillofacial Surgery ◽  
Pathological Process ◽  
Oral And Maxillofacial Surgery ◽  
Comprehensive Treatment ◽  
Drug Addicts ◽  
Psychoactive Substances ◽  
Pathogenetic Therapy ◽  
Destructive Processes ◽  
Almost All

The aim: The aim of our research is to study the features of toxic osteomyelitis in drug addicts, their diagnosis and comprehensive treatment, aimed at strengthening motivation for the suspension of the use of psychoactive substances and the elimination of the pathological process in the lower jaw . Materials and methods: The features of toxic osteomyelitis, complicated by abuse, have been studied on 46 patients in the department of oral and maxillofacial surgery of Lviv regional clinical hospital during 2013-2019. Psychoactive substances, used by the patients, varied from homemade drugs “Screw” taken by 32 men (69.5%), synthetic drug amphetamine consumed by 10 men (21,7%) to Subutex used by 4 patients (8,7%) for their pleasure. All the patients underwent comprehensive examination, which included clinical, laboratory, radiological, pathohistological studies. Almost all patients – 41 ( 89.1% ) underwent sequestrectomy. Results: Clinical picture progressed quite rapidly in the form of diffuse destructive-necrotic osteomyelitis of the mandible, which was characterized by a severe, atypical course of the pathological process with permanent inclusion of other additional areas of the lesion of the mandible. The X-ray at this stage showed an increase in destructive processes in the bone. Conclusions: Appropriate surgical tactics and pathogenetic therapy are of great importance for toxic osteomyelitis in drug addicts. Due to the treatment, despite the total destruction of the mandible, it was possible to stop the destructive bone processes and to preserve life for such patients.

scholarly journals Prospective study on the clinico-hematological profile of dengue fever patients in Navi Mumbai

2021 ◽  
Vol 8 (4) ◽  
pp. 569
Author(s):  
Prachi Sankhe ◽  
Priyanka Jadhav ◽  
Praveen Meduri
Keyword(s):  
Dengue Fever ◽  
Prospective Observational Study ◽  
Clinical Laboratory ◽  
Dengue Infection ◽  
Radiological Findings ◽  
Hematological Profile ◽  
Entire Duration ◽  
Wbc Count ◽  
Almost All ◽  
Biochemical Abnormalities

Background: It has been seen that epidemiology and clinical presentation of dengue infection differs significantly across geographical areas. The present study was done to study clinico-hematological profile of patients with dengue fever in Navi Mumbai, Maharashtra.Methods: This prospective observational study was conducted at a tertiary level teaching hospital in Navi Mumbai. All patients were observed over their entire duration of their hospital stay (up to 7 days). We included adult patients of both gender (males or females) who were admitted with clinically and serological diagnosed dengue fever, consenting to participate in the study.  The clinical, laboratory and radiological findings of the patients were noted.Results: All 80 patients presented with fever while 71.25% had myalgia. Retro-orbital pain, rash and vomiting was observed in 38%, 26% and 26% respectively, whereas 23.75% patients were having cough and bleeding from any site. Three fourths of the patients were diagnosed with dengue, 18.75% and 6.25% were diagnosed with DHF and DSS. respectively. Hepatosplenomegaly was increasing from day 1 (9%) to 6th (60%) and 7th (60%) day. Mean haemoglobin levels and haematocrit started increasing from second day onwards, while WBC count and platelet count increased gradually from first day onwards. Splenomegaly was diagnosed in 3.75% of patients while hepatosplenomegaly and fatty liver was observed in 8.75% and 2.5% respectively. There were two deaths, both were cases of DSS.Conclusions: Almost all the patients included in our study showed both haematological and biochemical abnormalities. 

scholarly journals Volumetric absorptive microsampling at home as an alternative tool for the monitoring of HbA1c in diabetes patients

2017 ◽  
Vol 55 (3) ◽  
Author(s):  
Nick Verougstraete ◽  
Bruno Lapauw ◽  
Sara Van Aken ◽  
Joris Delanghe ◽  
Christophe Stove ◽  
...  
Keyword(s):  
Median Time ◽  
Clinical Laboratory ◽  
Blood Collection ◽  
Diabetic Patients ◽  
Novel Technique ◽  
Reliable Tool ◽  
Standard Techniques ◽  
Blood Spot ◽  
Volumetric Absorptive Microsampling ◽  
At Home

AbstractBackground:Microsampling techniques have several advantages over traditional blood collection. Dried blood spot (DBS) sampling and blood collection with heparinized capillaries are the standard techniques. Volumetric absorptive microsampling (VAMS) is a novel technique that collects a fixed volume of blood by applying an absorbent tip to a blood drop. In the present study we explored the feasibility of HbAMethods:Diabetic patients were enrolled in this study during consultation with the endocrinologist. A venous (adults) or capillary (children) sample was taken for immediate HbAResults:The median time between sampling at home and analysis was 3 days. Results of HbAConclusions:Utilizing equipment standard available in the clinical laboratory, the use of home-sampled dried VAMS and DBS is not a reliable tool for the monitoring of HbA

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